Pre-Endoscopy Rockall Score
Estimates risk of mortality in upper GI bleeding before endoscopy
Score interpretation
Pre-Rockall 0: 0.2% mortality. Excellent prognosis.
→ Consider early discharge post-endoscopy if no high-risk stigmata
Pre-Rockall 1–2: 2.4% mortality.
→ Admit; urgent endoscopy within 24h; PPI therapy
Pre-Rockall 3–4: 11.2% mortality.
→ Admit; urgent endoscopy; IV PPI; GI review
Pre-Rockall 5–7: >24% mortality.
→ HDU/ICU level care; emergency endoscopy; IV PPI; surgical/GI on-call
Interpretation bands for the Pre-Rockall. Apply clinical judgement and local guidance.
References
- Rockall TA, et al. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996;38(3):316–21.
Related
Curated clinical cross-links plus same-class fallbacks.
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
The Pre-Rockall is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.